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Relationships - May 2012

Every month Maggi Stamp, a qualified and experienced relationship counsellor in private practice after 20yrs with Relate, writes about some of the emotional challenges we meet as we pass our half-way markers.

For reasons of confidentiality Maggi never writes about a particular person's problems unless you have sent one in to be answered, but all her examples are based on problems raised by clients, family and friends over the years.

I am worried about my son's depression

I am worried about my son’s depression. He’s had one suicide attempt with iboprufen and an episode of suicidal thoughts. He is on active military duty and has lived with his girlfriend for the past two years. She has a bipolar condition.

He started Zoloft almost two weeks ago and seems to feel better. I am currently staying with him while his girlfriend was out of town. Since she came back three days ago I notice she is sometimes harsh on him and sometimes very loving. My concern is that her health issues may affect his recuperation. There is a huge age gap between them, he is 23 and she is in her 40s. I need advice on how to deal with this situation because I fear for his safety.

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As they cuddle their newborn, I wonder how many mothers are truly aware they will never lose their natural need to nurture - that motherhood is for life. Most mothers will always be ready to care for and about their offspring regardless their – or her – age. Once our son or daughter is into adult-hood there’s little practical caring we can do without their invitation. We’re destined to stand back and watch in the hope that they remember we are there if needed.

This loving mum has travelled a great distance to be with her very depressed son and it is good that he is responding to his medication.

She obviously has concerns not only about his attempted suicide and the recurrence of suicidal thoughts, but about his work – he is on active military service, and about the relationship he is in.

First let’s look at the suicidal aspects of depression. This illness can affect young men in their early twenties particularly hard. It seems that suicide attempts and suicidal thoughts are more common in this group than others. So this mother’s fears for her son’s safety are very real. The positive thing here is that he sought help and is beginning to feel the benefit of his medication. His particular one is in the SSRI group of drugs (serotonin reuptake inhibitors) which affect the imbalance in chemicals in the brain known to cause depression, panic, and anxiety. I am sure he or his mother will have researched the nature of Zoloft (an American trade name for the medication) and will be aware of the need to maintain contact with his medical care team, report any unwanted effects of the drug and stick closely to the guidance enclosed in the pill pack. He should also always consult his doctor if he wants to come off the drug – and I would hope that he feels confident enough to want this to happen at some point during this year. Sudden stops in the medication can put him right back where he started so withdrawal needs to be closely managed and monitored. During this time I would also hope that he is offered some sort of counseling therapy as well. If he is working in the armed forces this should not be an added personal expense.

Being on active military service – though I would imagine on sick leave – does raise the issue of triggers to depression unique to servicemen and women. I don’t know if he has been posted abroad recently or is waiting to be deployed, but this adds to the stresses experienced by young people. If he is trained but waiting he will have heard and seen some of the reports coming from zones of aggression which will be un-nerving and will quite naturally fill anyone with an imagination with apprehension.
If he has already had postings to Afghanistan or elsewhere then there is the possibility that an aspect of his depression might be PTSD (Post Traumatic Stress Disorder). This condition has been documented for many years – as early as WW1, when it was known as shell-shock. It can affect anyone who has been exposed to a severe and violent event, not just in war zones, where many awful things will be witnessed or experienced, but wherever something shocking and upsetting occurs – traffic accidents, muggings, robberies and sexual abuse or rape are the most obvious. But earthquakes, floods, tsunami, or other natural disasters can have the same effect.

Everyone deals with experiences in different ways and I’m relieved the UK and US military now claim to acknowledge their responsibility of care for the returning troops (1 in 8 in the US) who show signs of suffering from PTSD.
PTSD affects people in different ways, there might be :-

recurring nightmares or sleep disturbance,

an inability to relax

nervousness at sudden sound or movement

intolerance of noisy music, machines or children

avoidance of close relationships

some sufferers will plunge headlong into a period of hyperactivity such as partying every night or drinking too much

some will become withdrawn and retreat from the world in general. (Some Vietnam veterans have been known to do this on returning home with no on-going support from their military employer and have lived for many years in the backwoods, avoiding contact with other people altogether)

The shock to the person’s system of doing or seeing awful things – or even of not doing what they think they ‘should’ have done in that situation – is enough to set up the imbalance of brain chemicals like serotonin and adrenalin which, without sufficient de-briefing and follow-up support, can tip someone into depression.

The young man’s girlfriend has mental health problems which will change her behaviour from time to time. This might be disruptive to his need for stability. The partner of someone with a bi-polar condition will need to be strong and steadfast themselves in order to cope when the sufferer launches into a period of extreme behaviour, wakefulness or desperation. It might be more than he can offer right now. She is much older than him and that too carries various issues that could be de-stabilising unless the couple have been able to identify them and thoroughly discuss strategies for dealing with future issues.

I am 14 years younger than my husband and, before we married, we spent many hours discussing the possible difficulties that gap might create in our life together and how we might avoid or get through problems should they occur. Even now occasionally something will catch us by surprise and we have to deal with it ‘on the hoof’, like my fancying something loud from the 60’s on the cd player and his wanting a bit of Schubert or tv preferences. As we spent time acknowledging these things might happen they seldom cause us much angst, but if a couple relies on ‘the power of love’ to get them through, they need to get real and talk. I’m sure that power comes into the equation but life is built around working at being loving, honest and realistic at the same time. It takes practice.

What can you do to help your son? You’ve already been of great support to him and I’m sure will continue to be.

It is vital that he has someone he can be entirely open with. If he receives comments which diminish the importance – in his own mind – of what he is saying, then he will just stop saying things. It is necessary to keep the lines of communication open no matter what one hears. It is often more helpful to speak to a counselor as there are some things which might be very hard for a parent to hear without showing their own shock or hurt – or hard him to say, knowing that would be the result.

The best way to be an effective support is to talk and listen.

Ask him how you can help.

Be ready to hear whatever he wishes to say, without any judgment upon it.

Speak to the military medical personnel as his mother and find what further care and on-going support is available for him.

You have no control over his relationship. He is an adult and must make his own decisions – and learn from whatever mistakes he might make. We all make them and, generally, learn from them.

Might he be worrying over how best to support his girlfriend?

Might he be concerned that if he gets a posting she will be left alone?

Might he want to end the relationship but daren’t in case it upsets her bi-polar condition?

Again, encourage him to talk but don’t judge or tell him what to do.

Acknowledge his difficulties, ask him what he would like to do, even if he thinks it impossible. With encouragement he might be able to break this down into small, gradual steps.

Good luck, and thank you for raising such varied issues in one email.

See:

www.mind.org.uk/
What is Mental Illness? What Can You Do About It? Mind has the Info.